Magnesium in pregnancy blood pressure and pre-eclampsia – A review

Exploring the Complex Interplay of Trace Elements and Their Association with the Risk of Development of Pre-eclampsia in Pregnancy: a Case-Control

Pre-eclampsia, a hypertensive disorder occurring during pregnancy, poses significant risks to maternal and fetal health worldwide. Despite extensive research, the precise cause of pre-eclampsia remains unknown. Recent studies have indicated that trace elements, essential minerals crucial for various biological processes, might be significant factors in the development of pre-eclampsia. This study examines the intricate relationship between trace elements (magnesium, copper, zinc, calcium, phosphorus, and iron) and the severity of pre-eclampsia. The study involves a total of 150 participants, categorized into three distinct groups: 50 individuals with mild pre-eclampsia, 50 with severe pre-eclampsia, and 50 healthy pregnant controls. Specifically, out of the 100 pre-eclampsia cases, 5 were identified as early-onset and 95 as late-onset. Participants were recruited from a tertiary care hospital based on stringent inclusion and exclusion criteria. All the trace elements were quantitatively measured by direct colorimetric method using the Beckman Coulter AU480 analyzer system (Beckman Coulter, USA). Pre-eclampsia cases exhibited a significantly lowered level of magnesium (2.02 mg/dL), zinc (57.62 mg/dL), calcium (8.02 mg/dL), and phosphorus (3.93 mg/dL). These levels were approximately 14.4%, 20.2%, 21.1%, and 22.6% lower when compared to healthy pregnant women. Conversely, copper (151.67 mg/dL) and iron (53 μg/dL) levels were significantly elevated in pre-eclampsia cases. Age emerged as a significant risk factor, correlating with heightened pre-eclampsia susceptibility. Magnesium showed a protective effect, correlating negatively with age and positively with gestational age. The complex relationships between trace elements, age, and pre-eclampsia underline the need for personalized interventions, potentially including magnesium supplementation, in high-risk pregnancies.

The Use of Saccharomyces cerevisiae Supplemented with Intracellular Magnesium Ions by Means of Pulsed Electric Field (PEF) in the Process of Bread Production

Bread was supplemented with magnesium through an addition of yeasts subjected to the effect of PEF at optimised parameters to obtain the maximum bioaccumulation of magnesium in cells. Bread produced with the use of yeasts supplemented with magnesium by means of PEF was characterised by its highest content, at 39.3 mg/100 g, which was higher by 50% and 24%, respectively, compared to the control bread sample with an admixture of yeasts cultured without any addition of magnesium and with no PEF treatment and to the control bread sample with an admixture of yeasts cultured with an addition of magnesium but no PEF treatment. The addition of yeasts supplemented with magnesium using PEF in bread production did not cause any statistically significant changes in the chemical composition of any of the analysed samples. However, statistically significant changes were noted in the technological properties of breads produced with an admixture of yeasts supplemented with magnesium by means of PEF treatment. An increase of moisture to 54.03 ± 0.29% led to a reduction of the total baking loss. No statistically significant differences were noted in the bread volume in samples K1, K2, and P, varying from 239 to 269 cm3/100 g.

Effect of electroporation in a continuous flow system on bioaccumulation of magnesium, zinc and calcium ions in Lactobacillus rhamnosus B 442 cells

Biomass of Lactobacillus rhamnosus B 442 was subjected to the continuous electroporation using an electroporator with a flow chamber (length of 10 cm, distance between electrodes 0.25 cm, stream width 0.25 cm, flow speed 10 mL/min) to improve accumulation of calcium, magnesium and zinc in the cells. For all tested ions, the following parameters were applied: voltage of 250 V (E = 1 kV/cm), 570 V (E = 2.28 kV/cm), 950 V (E = 3.8 kV/cm), and 1400 V (E = 5.6 kV/cm, the positive control), a frequency of 10 Hz, a pulse width of 100 µs and 30 electrical pulses. The use of PEF increased the accumulation of magnesium, zinc and calcium by 39, 73 and 162%, respectively, compared to the control. Positive correlation was found between ion accumulation and membrane permeability for zinc and magnesium. For calcium, the initial increase in permeability resulted in higher ion accumulation, but with a further increase of this parameter at 3.8 kV/cm, its decrease was observed caused by a drop in cell viability. Total number of bacteria ranged from 1.67 × 10⁸ (for the cultures supplemented with calcium) to 1.34 × 10¹² cfu/mL (for the cultures supplemented with magnesium).

Magnesium Supplementation and Blood Pressure in Pregnancy: A Double-Blind Randomized Multicenter Study

Objective

To investigate the effect of magnesium (Mg) supplementation in healthy pregnant women for prevention of blood pressure increase. Secondary outcomes were comparison of biomarkers for hypertensive disorders and labour and fetal outcomes between the groups.

Methods

Two hundred nulliparous healthy pregnant women were double-blind randomized to receive Mg daily or placebo.

Results

There were no differences in blood pressure increase. However, among the Mg-treated women, there was a significant negative correlation between increase in blood levels of magnesium and increase in systolic blood pressure (p = 0.042). Magnesium supplementation seems to be safe for both mother and infant.

Conclusion

Magnesium supplementation in healthy first-time pregnant women is not to be recommended for prevention of blood pressure increase. Supplementation in risk pregnancies needs to be further investigated. The study is listed on the ISRCTN registry with study ID 13890849.

Mechanisms of the effect of magnesium salts in preeclampsia

Preeclampsia is a heterogeneous pregnancy-specific syndrome associated with abnormal trophoblast invasion and endothelial dysfunction. Magnesium (Mg²⁺) level may be normal or decreased in women with preeclampsia. However, the use of Mg²⁺ salts, such as Mg²⁺ sulphate, are useful in reducing the pathophysiological consequences of preeclampsia with severe features and eclampsia. Although the mechanism of action of this Mg²⁺ salt is not well understood, the available evidence suggests a beneficial effect of Mg²⁺ for the mother and foetus. The mechanisms include a lower level of soluble fms-like tyrosine kinase 1 and endoglin, blockage of brain N-methyl-D-aspartate receptors, decreased inflammation mediators, activation of nitric oxide synthases, blockage of arginases, and reduced free radicals level. The maintenance of Mg²⁺ homeostasis in pregnancy is crucial for an appropriate pregnancy progression. Oral Mg²⁺ salts can be used for this purpose which could result in mitigating the deleterious consequences of this syndrome to the mother, foetus, and newborn.

Effect of Pulsed Electric Fields (PEF) on Accumulation of Magnesium in Lactobacillus rhamnosus B 442 Cells

The aim of this study was to determine the effect of pulsed electric fields (PEF) on accumulation of magnesium ions in Lactobacillus rhamnosus B 442 cells. Under optimized conditions, this is, on 15 min exposure of the 20 h grown culture to PEF of the 2.0 kV/cm and 20 µs pulse width at concentration 400 μg Mg²⁺/mL medium, accumulation of magnesium in the biomass reached maximum 4.28 mg/g d.m. Optimization of PEF parameters caused an increase of magnesium concentration in the cells by 220% in comparison to the control not treated with PEF. Bacterial cell biomass enriched with Mg²⁺ may be an alternative for pharmacological supplementation applied in deficiency of this cation.

Intake of antioxidant nutrients and coefficients of variation in pregnant women with preeclampsia

INTRODUCTION AND OBJECTIVE

Oxidative stress appears to play a critical role in the pathogenesis of preeclampsia. Evidence suggests that adequate intake of antioxidants can modulate this condition. The objective of this study was to assess the intake of antioxidant nutrients and coefficients of variation in pregnant women with preeclampsia.

METHODS

In a cross-sectional study in the public health network of the city of Maceió, Brazil, a dietary survey was performed consisting of 24-hour food recalls, with subsequent adjustment of nutrients using the estimated average requirement as the cutoff point, and a questionnaire on frequency of consumption of antioxidants.

RESULTS

We studied 90 pregnant women with preeclampsia (PWP) and 90 pregnant women without preeclampsia (PWoP) with mean ages of 25.8±6.7 years and 24.1±6.2 years (p=0.519), respectively. A low mean intake of antioxidants (vitamin A, selenium, zinc and copper) was observed in both PWP and PWoP, although intakes of vitamin A (p=0.045) and selenium (p=0.008) were higher in PWoP. In addition, we observed high coefficients of variation in nutrient intakes in both groups, which were higher for vitamin C (p<0.001), vitamin A (p=0.006) and copper (p=0.005) in PWP.

CONCLUSIONS

Consumption of antioxidant nutrients by pregnant women with preeclampsia is inadequate, with considerable daily variations in intake, which points to a need for nutrition education strategies aimed at improving intakes, because diet is without doubt a key factor in the modulation of oxidative stress caused by preeclampsia.